Telemedicine lets doctors diagnose remotely

Friday

Aug 11, 2017 at 3:15 PM

THE ISSUE: Using telemedicine, doctors can remotely diagnose or monitor some medical conditions, eliminating the need for an in-person visit.

THE IMPACT: Advocates of a pending telemedicine bill say it would increase efficiency and reduce healthcare costs. Some insurers say the bill’s approach to reimbursement rates would eliminate some cost savings.

Gerry Tuoti Wicked Local Newsbank Editor

Getting a diagnosis without seeing a doctor in person could become more common in the future.

“What we’re looking for is to establish a framework to allow for the use of telemedicine as a tool for healthcare providers in Massachusetts,” said Adam Delmolino, director of state government advocacy for the Massachusetts Health & Hospital Association.

Telemedicine — the use of online, video and photo technology to remotely diagnose or monitor certain medical conditions — can be an effective tool for healthcare providers, its proponents say. For people in rural areas, patients with impaired mobility and people who cannot easily travel due to a fragile medical state, telemedicine can save them a trip to see a doctor in person.

“It doesn’t replace in-person visits to doctors or healthcare providers,” said state Sen. Jason Lewis, D-Winchester. “I see it as complementary.”

Lewis filed legislation earlier this year to create regulations for the use and expansion of telemedicine in Massachusetts.

“Today, there are some challenges in Massachusetts,” he said. “One of the challenges is with insurance coverage. Most insurers don’t provide comparable coverage for telemedicine.”

For some patients, lack of access to the requisite technology at home could also pose a barrier.

Lewis’s bill would establish a streamlined credentialing process for health care providers to use telemedicine. It would also ensure parity between insurance rates for telemedicine and in-person visits.

Eric Linzer, vice president of the Massachusetts Association of Health Plans, argues that insurance reimbursement rates should be negotiated, not mandated by law. He also argued that the law, as written, wouldn’t deliver on cost savings.

“Where we have concerns is that this bill would require the same reimbursement as in-person visits, which would eliminate the cost savings for employers and consumers,” he said. “If the argument is that telemedicine is going to make healthcare more efficient, than requiring the same rates eliminates any potential savings for employers and consumers.”

He added that from the perspective of insurers, telemedicine does hold significant promise.

“Given that plans are covering and making plans available, they recognize the potential for telemedicine,” he said.

With telemedicine, Delmolino said, a dermatologist could record a skin exam on video, then have a specialist review it later on, potentially saving the patient a second visit and long wait, especially if there is a shortage of available specialists.

A pilot program in Gardner, he added, recently used telemedicine to remotely connect high school students with behavioral health specialists.

Due to a lack of neurologists in Massachusetts, telemedicine could also hold promise in that field, Delmolino added. Hospital staff, for example, could remotely connect with a neurologist to determine how to best triage a stroke patient.

“I think we’re thrilled with the opportunity to be allowing for the innovation of technology for this to be allowed in Massachusetts,” Delmolino said.

Lewis said his bill would leave the use of telemedicine to the discretion of healthcare providers and doctors.

“I expect the state Senate will put forward an omnibus bill on a variety of strategies to control healthcare costs,” he said. “I’m going to make the case that including the telemedicine bill would be a good idea.”

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